Nurse Practitioners

Can a nurse practitioner bill Medicare for public outpatients when the nurse practitioner is simultaneously being paid by a hospital that does not have a section 19(2) exemption?

30 September 24

I’m a Nurse Practitioner working in a small rural centre. I am a public employee 4 days a week and work privately on one day in the co-located primary health clinic/urgent care centre, which I bulk bill. A GP has left, and I have been asked to cover the clinic on two of my hospital days until a replacement is found. On these two days I am paid by the hospital as I still cover the emergency department. I have been asked to bulk bill the patients I see at the clinic on these two days even though I will be simultaneously being paid by the hospital. Both entities are wholly owned by the public health service, and it does not have a section 19(2) exemption. The GPs who work in the clinic are not employees of the public health service like me.

Can a fellow of the Australasian College for Emergency Medicine (FACEM) bill MBS codes outside of a private emergency department?

24 September 24

This FACEM was planning to open a walk-in emergency clinic similar to a GP urgent care centre. Importantly, this would not be an approved private emergency department (ED). The following scenarios were posed as part of the question. Scenario 1: A 68-year-old female presents to the treatment centre (FACEM lead) post fall and sustains a right wrist fracture & a laceration to her forehead. The patient is assessed by the FACEM which includes history, examination and organising investigations – some blood tests, ECG and X ray. As a part of treatment, the patient requires interpretation of an ECG, reduction of the fracture and application of plaster under a local block, and suturing of forehead laceration under local. Which code applies for the consult, is it 104 or 107? Which code applies for the fracture reduction and plaster application? Which code applies for the local block? Scenario 2: A patient presents with abdominal pain on a Sunday. The patient requires assessment by a FACEM, which includes, history, examination and organising investigations followed by treatment. Is seeing this patient on a Sunday considered an afterhours presentation? If yes, which code applies for the consult?